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Form 4070 Employee’s Report of Tips to Employer

Form 4070 Employee’s Report of Tips to Employer

www.irs.gov

Employee’s name and address Social security number Employer’s name and address (include establishment name, if different) Month or shorter period in which tips were received from , , to , 1 Cash tips received 2 Credit and debit card tips received 3 Tips paid out 4 Net tips (lines 1 + 2 - 3) Signature Date Form 4070 (Rev. 8-2005)

  Form, Month, Employee, Form 4070 employee, 4070, Form 7004

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